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Driver's Licence Application

Applicant Details

Date of Birth
Day
Month
Year
Multi-line address

The details provided will not be used for any other purpose without prior agreement.

Current Licence Held

Current Licence Held
FIA e-Licence
FIA Super Licence
ACO Le Mans Licence
National (specify)
None

Requested La’Bergitla Licence Level

Requested Level
Level A
Level B
Level C

Racing History (last 3 seasons)

Maximum 10

For each entry:

  • Season 

  • Championship / Series 

  • Team 

  • Category / Class 

  • Rounds Entered 

  • Best Result 

  • Final Standing 

  • Points Earned 

  • Electric / Hybrid Programme 

  • Evidence Upload (results logbook / timing sheets)

FIA Super Licence Points - Do you claim FIA Super Licence points?

If Yes:

  • Total Points (last 3 years)

  • Points Breakdown 

  • Verification Upload

Medical & Fitness

Issued Date
Day
Month
Year
Expiry Date
Day
Month
Year

Mandatory Training & Test

Test Status
Passed
Scheduled
Re-test
Date Passed/Scheduled
Day
Month
Year

Emergency Contact

Declarations

Payment

Licence Level Fee
£
Level A (per championship point): £1,649
£

Using Level A per-point rate only (excluding base): £1,649 × season points.

  • 1st (Champion): 465.4 × £1,649 = £767,444.60 → £767,445

  • 2nd: 338.6 × £1,649 = £558,351.40 → £558,351

  • 3rd: 280.3 × £1,649 = £462,214.70 → £462,215

Payment Method
Debit/Credit Card
Bank Transfer

If Bank Transfer:


Please make payment to the following account details:

Automobili La'Bergitla Endurance Operations LTD


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